HR – Work Experience and Work Placement Request Work Experience and Work Placement Request 1Introduction2Request You can use this form to Request to join the Swan Hill Rural City Council’s Work Experience Program Who can use this form Students from approved educational institutions (usually public and private schools, TAFE, universities and other employment training organisations) This form should be completed by students NOT teachers While completing this form, we will request Student details Contact details Education details Placement details including work preferences Contact details for an endorsee e.g a teacher that will endorse your application. It will take about 10 minutes to complete this form. After you submit this form We will send you an email receipt to confirm we have received your request A member of our Human Resources team will contact you within two weeks after applications have closed What happens with your information? Information requested on this form is required by Swan Hill Rural City Council in order to process your application. We will handle any personal information you provide on this form in accordance with the Privacy and Data Protection Act 2014. We record this information on our customer databases and make it available to relevant Council staff in line with our Privacy Statement. You can access your personal information by contacting our Privacy Officer. Student detailsName(Required)Email address(Required) Phone number(Required)Are you of Aboriginal or Torres Strait Islander descent?(Required) Yes No Any special needs / limitations(Required) Yes No Please specify any special needs / limitations(Required)Current educational information Name of institution(Required)Course(Required)Year of study(Required)e.g. Year 10 Placement requestWhich placement are you applying for?(Required) Work Experience Structured Workplace Learning Practical Placement Select preferred dates2026 - Proposed START date 2026 - Proposed END date How long would you like a placement with Council?(Required)This field is hidden when viewing the formSection BreakDo you have any special requests?(Required)e.g. Need more weeks, different start dates etc. Yes No Description of special requestThese requests will be considered, but only applicable if approved. What department would you like to work in?1st Preference (Required) Select a department Actions Edit Delete There are no 1st preference. Add 1st preference Maximum number of 1st preference reached. 2nd Preference (Required) Select a department Actions Edit Delete There are no 2nd preference. Add 2nd preference Maximum number of 2nd preference reached. Endorsee DetailsName(Required)Position(Required)Phone number(Required)Email address(Required) Student DeclarationDeclaration 1(Required) I have notified my Endorsee that they will be contacted to confirm the application.(Required) Declaration 2(Required) I have read, understood and agree to abide by the conditions stated at the top of this form if offered a work experience placement at Swan Hill Rural City Council. (Required)
